Melanocortin peptides or melanotropins, xcex1-MSH, xcex2-MSH, xcex3-MSH and ACTH, are involved in many physiological functions in vertebrates, mammals and in man. They regulate skin pigmentation and steroid production, modulate immune responses and learning processes, influence energy balance, growth and regeneration of nerves, and several other functions as well.
Five human receptors are known which interact with melanotropins, hMC-1R to hMC-5R. The receptors are seven-helix transmembrane-spanning receptors and belong to the superfamily of G protein-coupled receptors; their activation leads to elevation of cAMP. The melanocortin receptors 1, 3, 4 and 5 recognize xcex1-MSH, xcex2-MSH and xcex3-MSH, while melanocortin receptor 2 recognizes only ACTH.
Considerable attention has recently focused on melanocortin receptors 3 and 4 that are widely expressed in the central nervous system, and also on melanocortin receptor 5, found in the brain and in various peripheral tissues. The physiological role of hMC-3R and hMC-5R is not well defined, although hMC-5R has recently been implicated in control of lipid and pheromone production in exocrine glands. Rapidly growing pharmacological and genetic evidence suggests that hMC-4R is involved in regulation of the energy balance and body weight in rodents. The role of MC-4R in regulation of food intake and body weight is supported by results obtained from agonist/antagonist administration in rats and from murine genetics. Intraventricular administration of the agonist MTII reduced food intake and conversely, the antagonist SHU9119 increased food intake and body weight. Mice genetically deficient in the melanocortin receptor 4 develop obesity. It could be anticipated therefore that compounds active at MC-4R might be useful in the treatment of eating disorders.
Melanocortin receptor 4 appears to play a role in other physiological functions as well, namely in controlling grooming behavior, erection and blood pressure. The natural hormones, melanotropins, however, have relatively low affinity for hMC3-5R and are not particularly selective. In order to differentiate the physiological role of melanocortin receptor 4 from that of other melanocortin receptors in the brain, in particular from MC-3R, potent and selective antagonists are necessary. The synthetic ligands available at present do not distinguish between the melanocortin receptors. A frequently used research tool is the SHU9119 peptide, a potent antagonist at melanocortin receptors 3 and 4, and an agonist at melanocortin receptor 5. SHU9119 has been extensively studied in vitro and in vivo; injection of this peptide stimulates food intake in rats. A similar lactam derivative, the peptide MTII is a potent but non-selective agonist at hMC3-5R.
Recently several peptides, which are cyclized via disulfide bridges, have been reported as antagonists of the xcex1-MSH responses at MC-3R and MC-4R, and the most potent and MC-4R selective antagonists are HS014, HS024 and HS028. HS014 and HS028 are partial agonists at melanocortin receptors 1 and 5, whereas at the same receptors, HS024 is an antagonist. In rats these antagonists increase food intake and body weight. While SHU9119, HS014, HS024 and HS028 are potent antagonists at MC-4R, they are not sufficiently selective for MC-4R over the other MC receptors. Thus there remains a need to provide for potent and selective antagonists of MC-4R that will allow for the differentiation of the physiological roles of the MC-4 receptor from those of other melanocortin receptors. Such selective antagonists may also be useful as therapeutic agents for the diagnosis, treatment or prevention of diseases and disorders mediated through the MC-4 receptor, more particularly eating disorders related to underweight, cachexia or anorexia of any cause in humans.
The present invention provides cyclic peptides that are potent and selective antagonists of the human melanocortin-4 receptor. These compounds are useful as research tool for the determination of the physiological roles of the MC-4 receptor, as well as for the diagnosis, treatment or prevention of disorders or diseases mediated through the MC-4 receptor.
The present invention provides compounds of the formula I 
wherein
D represents that the amino acid is an D-amino acid;
m, n, p, q and r are independently 0 or 1, with the proviso that when p is 1, then either q is 1 or n+m is 1, and when p is 0, then q is 0 and m and n are each 1;
s is an integer from 1 to 4;
R1 and R2 are each hydrogen, or R1 and R2 together represent methylene, or R1 and R2 together represent a bond;
R3 is H, Ac, Nle or Nxe2x80x94Ac-Nle, with the proviso that when R3 is Nxe2x80x94Ac-Nle, r is 0;
R4 is xe2x80x94(CH2)3NH2 or 4-imidazolyl;
R5 is selected from 1- or 2-naphthyl, 3-benzothienyl, phenyl optionally substituted with a group selected from halogen, C1-4alkyl, and C1-4alkoxy;
R6 is xe2x80x94(CH2)2CH3, xe2x80x94(CH2)2NHC(xe2x95x90NH)NH2 or xe2x80x94(CH2)3NH2; and
R7 is 3-indolyl, 1- or 2-naphthyl, or phenyl optionally substituted with a halogen; or a salt thereof.
In one embodiment of formula I, r is 0. In another embodiment p and q are each 0. In yet another embodiment s is 3 or 4. In a preferred embodiment, r, p and q are each 0, s is 3 or 4, and m+n is 2.
In another embodiment of formula I, R1 and R2 are each hydrogen.
In another embodiment of formula I, R5 is selected from 2-naphthyl, benzothienyl, and 4-substituted phenyl where said substituent is C1-4alkyl, C1-4alkoxy or halogen. A subset within this embodiment provides compounds where R5 is selected from 2-naphthyl and 4-substituted phenyl where said substituent is t-butyl, methoxy, chloro, iodo or fluoro.
In yet another embodiment of formula I, R6 is xe2x80x94(CH2)2NHC(xe2x95x90NH)NH2.
In another embodiment of formula I, R7 is selected from 3-indolyl, 2-naphthyl and 4-halophenyl. A subset within this embodiment provides compounds where R7 is 3-indolyl.
Compounds of formula Ia represent a subset of formula I: 
where R1, R2 and s are as defined under formula I; R5 is selected from 2-naphthyl, benzothienyl, and 4-substituted phenyl where said substituent is C1-4alkyl, C1-4alkoxy or halogen; and R7 is 3-indolyl, 2-naphthyl or 4-halophenyl.
As used in the application, Ac is acetyl, Arg is arginine, His is histidine, D-(2xe2x80x2)-Nal is D-3-(2-naphthyl)alanine, Nle is norleucine, Trp is tryptophan. The amino acid components of formula I are L-amino acids unless specified otherwise.
Compounds of the present invention are potent and selective antagonists of the melanocortin-4 receptor, and as such are useful as analytical research tool for the study of the physiological roles of the melanocortin-4 receptor. In addition, compounds of the present invention are useful for the diagnosis, treatment and prevention of diseases and disorders that may benefit from the blocking of the MC-4 receptor, in particular diseases and disorders related to eating disorders.
For analytical and diagnostic purposes the compounds of the present invention can be used in radioactive form, including radioactive labels. In particular the compounds of the invention may be manufactured so as to incorporate radioactive iodine or tritium, or any other suitable radio nuclide. Such a radioactively labeled compound can be used in radioligand binding for the the quantification of specific melanocortin receptors, for the analysis of dissociation constant (Kis or Kds) of drugs competing with specific subtypes of melanocortin receptors, and for the localization of MC-receptors in tissues and tissue sections e.g. by use of receptor autoradiographic techniques. Principles of radioligand binding and receptor autoradiography are well known in the art. As an alternative the compound may be labeled with any other type of label that allows detection of the substance, e.g. a fluorescent label or biotin, and the resulting compound be used for the similar purpose as the radioactively labeled compound.
The compounds of the invention can also be manufactured so as to incorporate a group that can be activated by light, in particular UV-light, the purpose with such activation being to obtain a compound useful for covalent labeling of MC-receptor by use of the photoaffinity labeling technique. Photoaffinity labeling is a technique well known in the art which in the present context is useful for elucidating the structure and topological organisation of the MC-receptors. Thus photoactive derivatives of the compounds of the invention are also part of the present invention. Moreover, preferably photoactive derivates of the compounds of the invention may also be made to incorporate an easily detectable group or label, such as e.g. a radioactive atom, a fluorescent group and/or biotin.
The compounds of the invention can be labeled with gamma and/or positron emitting isotope(s). Such labeled compounds constitute very specific embodiments of the invention and may be administered systematically, or locally, to an animal, preferably a human. These labeled compounds are useful for imaging the in vivo levels and/or localization of MC-receptors by the use of well known techniques among which may be mentioned Scintigraphy, Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT). Using such methods information on the distribution and/or quantities of the specific MC-receptors in tissues of the animal or human subject to the investigation is obtained, and such information is of value for diagnosis of disease, in particular functional disturbances in the brain related to MC-receptors.
In addition to analytical and diagnostic utilities, peptides of the present invention may also be used to block the normal physiological response of cells to natural melanotropin (e.g., alpha.-MSH) at the MC-4 receptor. Accordingly, compounds of the present invention may be useful for the prevention and/or treatment of fever, pain, chronic inflammatory diseases, memory disturbances in particular in elderly people, including Alzheimer""s disease, nerve regeneration, pathological psychomotor functions of psychiatric conditions such as e.g. catatonic conditions, epilepsy,
One aspect of the present invention provides a method for the treatment of eating disorders related to underweight, cachexia or anorexia or bulimia of any cause in humans comprising administering to a person in need of such treatment an effective amount of a compound of formula I. In these conditions the administration of a compound of the invention will increase food intake, which improves the patients"" general condition, increases or restores their body weight and prolong their life. In particular the administration of the compound of the invention is beneficial in elderly patients, in cancer patients, and in patients treated with cancer chemotherapeutics, as these patients often suffers from lack of appetite, that often lead to decreased food intake and severe underweight.
Another aspect of the present invention provides a method for growth promotion in an animal which comprises administering to said animal an effective amount of a compound of formula I. In particular growth promotion is desired in animal breeding for meat production such as poultry, pigs and cattle.
Another aspect of the present invention provides pharmaceutical compositions which comprises a compound of Formula I and a pharmaceutically acceptable carrier. The pharmaceutical compositions of the present invention comprise a compound of Formula I as an active ingredient or a pharmaceutically acceptable salt thereof, and may also contain a pharmaceutically acceptable carrier and optionally other therapeutic ingredients. The term xe2x80x9cpharmaceutically acceptable saltsxe2x80x9d refers to salts prepared from pharmaceutically acceptable non-toxic bases or acids including inorganic bases or acids and organic bases or acids.
The compositions include compositions suitable for oral, rectal, topical, parenteral (including subcutaneous, intramuscular, and intravenous), ocular (ophthalmic), pulmonary (nasal or buccal inhalation), or nasal administration, although the most suitable route in any given case will depend on the nature and severity of the conditions being treated and on the nature of the active ingredient. They may be conveniently presented in unit dosage form and prepared by any of the methods well-known in the art of pharmacy.
In practical use, the compounds of Formula I can be combined as the active ingredient in intimate admixture with a pharmaceutical carrier according to conventional pharmaceutical compounding techniques. The carrier may take a wide variety of forms depending on the form of preparation desired for administration, e.g., oral or parenteral (including intravenous). In preparing the compositions for oral dosage form, any of the usual pharmaceutical media may be employed, such as, for example, water, glycols, oils, alcohols, flavoring agents, preservatives, coloring agents and the like in the case of oral liquid preparations, such as, for example, suspensions, elixirs and solutions; or carriers such as starches, sugars, microcrystalline cellulose, diluents, granulating agents, lubricants, binders, disintegrating agents and the like in the case of oral solid preparations such as, for example, powders, hard and soft capsules and tablets, with the solid oral preparations being preferred over the liquid preparations.
Because of their ease of administration, tablets and capsules represent the most advantageous oral dosage unit form in which case solid pharmaceutical carriers are obviously employed. If desired, tablets may be coated by standard aqueous or nonaqueous techniques. Such compositions and preparations should contain at least 0.1 percent of active compound. The percentage of active compound in these compositions may, of course, be varied and may conveniently be between about 2 percent to about 60 percent of the weight of the unit. The amount of active compound in such therapeutically useful compositions is such that an effective dosage will be obtained. The active compounds can also be administered intranasally as, for example, liquid drops or spray.
The tablets, pills, capsules, and the like may also contain a binder such as gum tragacanth, acacia, corn starch or gelatin; excipients such as dicalcium phosphate; a disintegrating agent such as corn starch, potato starch, alginic acid; a lubricant such as magnesium stearate; and a sweetening agent such as sucrose, lactose or saccharin. When a dosage unit form is a capsule, it may contain, in addition to materials of the above type, a liquid carrier such as a fatty oil.
Various other materials may be present as coatings or to modify the physical form of the dosage unit. For instance, tablets may be coated with shellac, sugar or both. A syrup or elixir may contain, in addition to the active ingredient, sucrose as a sweetening agent, methyl and propylparabens as preservatives, a dye and a flavoring such as cherry or orange flavor.
Compounds of formula I may also be administered parenterally. Solutions or suspensions of these active compounds can be prepared in water suitably mixed with a surfactant such as hydroxy-propylcellulose. Dispersions can also be prepared in glycerol, liquid polyethylene glycols and mixtures thereof in oils. Under ordinary conditions of storage and use, these preparations contain a preservative to prevent the growth of microorganisms.
The pharmaceutical forms suitable for injectable use include sterile aqueous solutions or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. In all cases, the form must be sterile and must be fluid to the extent that easy syringability exists. It must be stable under the conditions of manufacture and storage and must be preserved against the contaminating action of microorganisms such as bacteria and fungi. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (e.g. glycerol, propylene glycol and liquid polyethylene glycol), suitable mixtures thereof, and vegetable oils.
Pharmacologically effective amounts may vary from 0.001 mg/day/kg body weight to 1,000 mg/day/kg body weight. Any suitable route of administration may be employed for providing a mammal, especially a human with an effective dosage of a compound of the present invention. For example, oral, rectal, topical, parenteral, ocular, pulmonary, nasal, and the like may be employed. Dosage forms include tablets, troches, dispersions, suspensions, solutions, capsules, creams, ointments, aerosols, and the like. Preferably compounds of Formula I are administered orally. The effective dosage of active ingredient employed may vary depending on the particular compound employed, the mode of administration, the condition being treated and the severity of the condition being treated. Such dosage may be ascertained readily by a person skilled in the art.